Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 12/6/2009

Question
QUESTION: I have been on clindamycin for an abscessed tooth ( last tooth on rt side) that I had extracted 4 days ago. Although I have no pain, my lower jaw is still swollen and sort of firm.  Will it go away if I continue the antibiotic and salt water rinses?
Thank you so much for your time.

ANSWER: Carol - The swelling should go away with the clindamycin and salt water rinses, but occasionally drainage of the infection just with the warm salt water is not enough.  If the infection is trapped and bacteria cannot drain, a surgeon will need to do a simple incision and drainage.  If the swelling continues you should make an appointment with a local board certified oral and maxillofacial surgeon for an evaluation.

I hope the swelling recedes, but if it does not, get the area examined by a surgeon.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your quick answer. Tomorrow I'll be on the clindamycin for 7 days. It seems to be getting smaller, but is very firm to the touch. How long should should I take the clindamycin and salt water rinses before I seek a oral surgeon?
Can you give me a ball park figure on what this is gonna cost?
I thank you again for your very quick response and your knowledge.
Carol

ANSWER: Carol - If the area is getting smaller with the antibiotic and the rinses, then no furthr treatment may be necessary.  If, however, it continues or swells again, the drainage will be necessary.  That is not an overly expensive procedure, but the amount varies so much with where you live.  

So see if it gets better on its own.  Hopefully that is what is best, but if drainage is necessary it should not be overly expensive.

---------- FOLLOW-UP ----------

QUESTION: It seems to be gettig smaller, but is still fairly firm. How long should I give the rinses & antibotic to work? It'll be a week tomorrow I've been on them and they run out then.
Should I get a refill for another 7-10 days??? I mean, what is the length of time I should take them and when to seek further advise???
I am in Oregon, an my dentist charged me $477 just to pull the tooth, so I am leary of what an oral surgeon would cost!
Thank you so much for all your help.
Carol

Answer
Carol -  Even though infection would be gone, the swelling in the area can remain for a period of time.  As long as the source of the infection, the infected tooth, is gone, the swelling should resolve but slowly.  The body tends to wall of these infection and this walling off is what takes time to reshape itself.  Warm salt water rinses should continue until all the swellings have disappeared.  How long of a time?  That is hard for me to say.  Just be patient and I think you will see complete healing within a few weeks.